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The Finger, PEP and at 3 days from exposure...
Nov 27, 2010

Dr. B-

Firstly, thanks so much for the immeasurable amount of time, insight and expertise put forth. It's is most appreciated.

Ok, quick question - will keep it simple with the facts.

1. Female sex worker performed fellatio with a condom (learning from the experts, obviously not a cause for any serious alarm as it also stayed intact.

2. No type of intercourse was involved.

3. However, while performing fellatio, she did stick her finger up my you know what for a few minutes.

I know that PEP is only for specific, occupational or very high-risk unprotected sex. Am I being rational in guessing that PEP would not be warranted for this type of situation?

No visible blood, cuts, etc. were noticed of any sort on her hand. She simply licked her finger, dabbed a spot of KY and then went up there with the good ole' index finger for a few mins.

I'm really guessing NO for this situation, but should PEP ever be needed within the 72 hour window period, would a hospital be the fastest place to grab a 28 day course? I'm sure many HIV specialist may not be as accessible on a weekend or holiday, so just want a little insight into where a PEP course would be most accessible. I'm in NYC.

I think I'm just over the 72 hour mark, so...

Hope you had a great T-day!

Health (And Universal Health Insurance) to all!

Cheers,

-One of the Good Guys

Response from Dr. Frascino

Hello One of the Good Guys,

You are absolutely correct: PEP would not be warranted, as your HIV-acquisition risk is negligible at best.

If PEP were warranted, any ER or urgent care center would be able to get someone started on treatment immediately. Anyone who has an HIV exposure significant enough to warrant a course of PEP should, however, be followed by an HIV specialist during the 28-day course of treatment.

Returning to your situation, your HIV risk is negligible. Consequently, neither testing nor PEP is warranted. This assumes the latex condom was used properly and that the skin on the probing index finger was intact.

Happy Thanksgiving Leftovers Day!

Dr. Bob



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